#### The bottom line Carpal tunnel syndrome is the most commonly diagnosed compression neuropathy of the upper limb. Patients may present to general practitioners, physiotherapists, hand therapists, or surgeons with a variety of symptoms. Several studies have examined the epidemiology, diagnosis, and treatment of carpal tunnel syndrome. We review these resources to provide an evidence based guide to the diagnosis and treatment of carpal tunnel syndrome. #### Sources and selection criteria We searched PubMed, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature to identify source material for this review. We examined available evidence published in the English language for the diagnosis and treatment of carpal tunnel syndrome. The search terms used were “carpal tunnel”, “carpal tunnel syndrome”, “tingling fingers”, “median nerve compression”, and “compression neuropathy”. There were no well conducted large randomised trials. We selected and examined smaller randomised trials as well as case series, cohort studies, and observational reports where these provided the only evidence. Carpal tunnel syndrome encompasses a collection of symptoms: patients often mention altered sensation or pain in the hand, wrist, or forearm. The reported prevalence of carpal tunnel syndrome is between 1% and 7% in European population studies, and most studies cite a figure of around 5%.1 2 It has been found to …